Illinois Bets on Medicaid Expansion

If the federal government keeps its promise to pay 90 percent of the costs for Obamacare, Illinois will have to find $1.8 billion a year to pay for the massive Medicaid expansion now on its way to Democratic Gov. Pat Quinn’s desk.

But what happens if Congress doesn’t keep that promise? Illinois lawmakers largely avoided the question in their floor debate over the expansion in May.

State Rep. Sara Feigenholtz, D-Chicago, said she is confident the federal government will pay 90 percent of the costs for as many as 700,000 new Medicaid enrollees in Illinois.

“I don’t believe, ever in the history of Medicaid, the federal government has rolled back a program,” Feigenholtz said.

However, President Obama proposed reducing federal Medicaid spending by $100 billion over ten years in a proposal during the 2012 super committee, which could affect Illinois significantly.

Disagreements Over Budgeting

Illinois will offer Medicaid to low-income, single, childless men and others who have not qualified for the government medical care in the past. Feigenholtz said Illinois is budgeting for 342,000 people to become eligible on January 1st. But Republicans such as state Rep. David Harris of Arlington Heights, say that number could be as high as 700,000.

“If we add 342,000 individuals to Medicaid,… after the federal reimbursement expires we are going to add $573 million to our budget responsibilities,” said Harris, warning the newly eligible Medicaid patients would add another $1.2 billion to Illinois’ bottom line.

“We are about to take an action that is going to add $1.8 billion to our budget,” Harris said. “Those are dollars we simply do not have.”

System Already Strained

Illinois spent about $17 billion on Medicaid last year, and $10 billion of that came from the federal government. Nearly 20 percent of the state’s population—or 2.7 million in all—are enrolled in Medicaid.

State Rep. Dennis Reboletti, R-Elmhurst, said adding another 300,000 or 700,000 to the program could hurt the people who truly need government health care.

“Why are we going to hand them a useless piece of paper and say, ‘Oh look, you have health care now,’ when doctors aren’t taking it?” Reboletti said.

Feigenholtz countered Illinois could save money as uninsured people are placed into managed care and taken out of the state’s emergency rooms.

She called the decision to implement Obamacare and expand Medicaid “a watershed moment” for Illinois and the “cornerstone” of Obama’s presidency.

Unaffordable Promises

State Rep. Jeanne Ives, R-Wheaton, however, says Illinois is scrambling to be a poster child for Obamacare without a thought to what it will cost the state.

“We are about to make promises we cannot keep,” Ives cautioned lawmakers. “Promising benefits that we cannot afford, and that people cannot access, … is the wrong way to care for our most needy.”

Democrats in the Illinois House used their overwhelming majority to force through the Medicaid expansion, which will soon be signed by Gov. Quinn.